103 STAT. 2282 PUBLIC LAW 101-239—DEC. 19, 1989 Federal Register, publication. (1) IN GENERAL.—The Secretary of Health and Human Serv- ices shall develop, by not later than one year after the date of the enactment of this Act and in consultation with the Sec- retary of Agriculture, a model application form for use in applying, simultaneously, for assistance for a pregnant woman ^ or a child less than 6 years of age under maternal and child assistance programs (as defined in paragraph (3)). In developing such form, the Secretary is not authorized to change any requirement with respect to eligibility under any maternal and child assistance program. (2) DISSEMINATION OF MODEL FORM.— The Secretary shall pro- vide for publication in the Federal Register of the model ap- plication form developed under paragraph (1) and shall send a copy of such form to each State agency responsible for admin- istering a maternal and child assistance program. (3) MATERNAL AND CHILD ASSISTANCE PROGRAM DEFINED. — In this subsection, the term "maternal and child assistance pro- gram" means any of the following programs: (A) The maternal and child health services block grant program under title V of the Social Security Act. (B) The medicaid program under title XIX of the Social Security Act. (C) The migrant and community health centers programs under sections 329 and 330 of the Public Health Service Act. (D) The grant program for the homeless under section 340 of the Public Health Service Act. (E) The "WIG" program under section 17 of the Child Nutrition Act of 1966. (F) The head start program under the Head Start Act. (b) FOR MEDICAID PROGRAM. — (1) IN GENERAL.— The Secretary of Health and Human Serv- ices shall, by not later than 1 year after the date of the enactment of this Act, develop a model application form for use in applying for benefits under title XIX of the Social Security Act for individuals who are not receiving cash assistance under part A of title IV of the Social Security Act, and who are not institutionalized. In developing such model application form, the Secretary is not authorized to require that such form be adopted by States as part of their State medicaid plan. (2) DISSEMINATION OF MODEL FORM.—The Secretary shall pro- vide for publication in the Federal Register of the model ap- plication form developed under paragraph (1), and shall send a copy of such form to each State agency responsible for admin- istering a State medicaid plan. 42 USC 701 note. SEC. 6507. RESEARCH ON INFANT MORTALITY AND MEDICAID SERVICES. The Secretary of Health and Human Services shall develop a national data system for linking, for any infant up to age one— (1) the infant's birth record, (2) any death record for the infant, and (3) information on any claims submitted under title XIX of the Social Security Act for health care furnished to the infant or with respect to the birth of the infant. 42 USC 1396a note. Federal Register, publication.
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